Medication verification method and system

ABSTRACT

A medication dispensing system includes an automated dispensing device that includes cells with electronically activated locks. The device is configured to detect when medication counts in the cells fall below predetermined thresholds. The system further includes a plurality of first electronic devices that are associated with some of the cells and that have imagers. In response to any of the medication counts in the cells being below the predetermined threshold, the automated dispensing device is configured to automatically send a replenishment needed notification to the first electronic device associated with the cell. That first electronic device is configured to transmit a picture of a medication to a second electronic device. In response to a positive verification by a user of the second electronic device that the medication in the picture is the correct medication, the second electronic device is configured to transmit an unlock signal to the automated dispensing device.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.17/064,735, which was filed Oct. 7, 2020. The entire disclosure of saidapplication is incorporated herein by reference.

BACKGROUND OF THE INVENTION 1. Field of the Invention

The present invention is related generally to high volume filling centerpharmacy. More specifically, the present invention is related to asystem in a high volume filling center, which allows medications in thehigh volume filling center to be restocked in a more efficient manner.

2. Related Art

A high volume pharmacy may process and fill a large number ofprescriptions and prescription orders using one or more automatedsystems. One such automated system is a high volume filler, which canautomatically dispense measured quantities of pills from respectivecells into appropriate containers that are then individually sent tocustomers. It is of significant importance that the medications, whichare placed into the cells, are accurate in order to ensure that eachuser receives the correct medications.

SUMMARY OF THE INVENTION AND ADVANTAGES

An aspect of the present disclosure is related to a method ofreplenishing a medication in an automatic medication dispensing devicefor filling a plurality of containers with the medications. The methodincludes the step of preparing the automated dispensing device. Theautomated dispensing device includes a plurality of cells containing andassociated with medications to be dispensed to the containers. The cellsare locked by a lock that can be electronically activated. The methodproceeds with determining that a medication count in a first cell of theplurality of cells is below a predetermined threshold. The methodcontinues with the step of imaging a medication with a first electronicdevice to produce an image. The method proceeds with the step oftransmitting the image of the medication from the first electronicdevice to a second electronic device that is remote from the firstelectronic device. The method continues with the step of comparing themedication in the image to a known medication associated with the firstcell to determine if the medication in the picture is the correctmedication for replenishing the first cell. The method proceeds with thestep of transmitting an unlock signal from the second electronic deviceto the automated dispensing device to unlock the first cell only inresponse to a positive determination that the medication in the image isthe correct type of medication for replenishing the first cell. Themethod continues with the step of unlocking the first cell in responseto the automated dispensing device receiving the unlock signal from thesecond electronic device. The method proceeds with the step ofreplenishing the first cell with the medication.

In an embodiment, the first electronic device is a technician devicethat is mobile and is operated by a technician on location at theautomated dispensing device, and the second electronic device is apharmacist device that is operated by a pharmacist.

In an embodiment, the image is a photograph, and the method furtherincludes the step of displaying the photograph of the medication on thepharmacist device along with a photograph of the medication associatedwith the first cell.

In an embodiment, the method further includes the steps of photographinga door of the first cell with the technician device and transmitting apicture of the door from the technician device to the pharmacist device.The step of transmitting the unlock signal from the pharmacist device tothe automated dispensing device is also only in response to a positiveverification that the picture of the door shows the first cell.

In an embodiment, the method further includes the steps of photographinga medication container that contains the medication with the techniciandevice and transmitting a picture of the medication container to thepharmacist device. The step of transmitting the unlock signal from thepharmacist device to the automated dispensing device is also only inresponse to a positive verification that the picture of the medicationcontainer shows the correct medication container for replenishing thefirst cell.

In an embodiment, the method further includes the step of displaying allof the picture of the medication, the picture of the door, the pictureof the medication container, and a picture of the medication associatedwith the first cell in a single user interface on the pharmacist device.

In an embodiment, the method further includes the step of storing thepictures of the medication, the door, and the medication container in amemory.

In an embodiment, prior to the step of replenishing the first cell withthe medication, the method further includes the steps of opening thefirst cell, scanning a code on an inside of the cell, verifying thefirst cell, and only unlocking the first cell in response to the firstcell being verified.

In an embodiment, the step of verifying the first cell is performed bythe technician device.

Another aspect of the present disclosure is related to a medicationdispensing system. The medication dispensing system includes anautomated dispensing device that includes a plurality of cells that canbe individually and electronically locked and unlocked. Each of thecells is able to contain a plurality of medications. The automateddispensing device is configured to determine a medication count in eachof the cells. The automated dispensing device is also configured todetect when the medication count in each of the cells falls below apredetermined threshold. The medication dispensing system furtherincludes a plurality of first electronic devices. Each of the firstelectronic devices includes an imager and is in electrical communicationwith the automated dispensing device and is associated with a pluralityof the cells of the automated dispensing device. In response to theautomated dispensing device detecting that any of the medication countsin the plurality of cells is below the predetermined threshold, theautomated dispensing device is configured to automatically send areplenishment needed notification to the one of the first electronicdevices associated with the cell. In response to receiving areplenishment needed notification, each of the first electronic devicesis configured to transmit a picture of a medication to a secondelectronic device. In response to a positive verification by a user ofthe second electronic device that the medication in the picture is thecorrect medication to replenish the cell with the medication count belowthe predetermined threshold, the second electronic device is configuredto transmit an unlock signal to the automated dispensing device tounlock the cell.

In an embodiment, each of the first electronic devices is a techniciandevice for use by a technician, and the second electronic device is apharmacist device for use by a pharmacist.

In an embodiment, each of the technician devices includes a displayscreen and is configured to display a first graphical user interfaceincluding the pictures taken with the camera of the technician deviceprior to the pictures being transmitted to the pharmacist device, andthe first graphical user interface includes a manually selectable optionto allow the technician to re-take any of the pictures.

In an embodiment, the pharmacist device includes a display screen thatis configured to display a manually selectable queue of techniciandevices awaiting verification.

In an embodiment, the queue of technician devices awaiting verificationare organized according to a priority score that is based on the urgencyto replenish the respective cells those technician devices areassociated.

In an embodiment, each of the cells has a door that can be opened andclosed, and an outer surface of each cell includes an image of themedication contained inside the cell.

Yet another aspect of the present disclosure is related to a method ofreplenishing an automatic medication dispenser. The method includes thestep of preparing a plurality of cells. Each cell contains a pluralityof medications to be dispensed into containers. The method proceeds withthe step of associating a plurality of technician devices with theplurality of cells such that each cell is associated with at least oneof the technician devices. The technician devices are in electricalcommunication with a pharmacist device. The method continues with thestep of receiving a notification on a first technician device of theplurality of technician devices that a first cell requiresreplenishment. The method proceeds with the step of transmittingpictures of a first replenishment medication and of the first cell fromthe first technician device to the pharmacist device. The methodcontinues with the step of receiving a notification on a secondtechnician device of the plurality of technician devices that a secondcell requires replenishment. The method proceeds with the step oftransmitting pictures of a second replenishment medication and of thesecond cell from the second technician device to the pharmacist device.The method continues with the step of displaying a queue containing thefirst and second technician devices on the pharmacist device. The methodproceeds with the step of selecting one of the first and second cellswith the pharmacist device. The method continues with the step ofdisplaying the pictures from the selected one of the technician deviceson the pharmacist device for approval by a pharmacist. The methodproceeds with the step of transmitting an unlock signal from thepharmacist device to the first or second cell to unlock a door of thefirst or second cell in response to approval of the pictures by thepharmacist on the pharmacist device.

In an embodiment, the queue organizes the first and second techniciandevices according to a priority score.

In an embodiment, the priority score is based on urgency that the cellsrequiring replenishment will run out of medications.

In an embodiment, an external device including a memory is provided, andthe method further includes the step of storing the pictures of thefirst and second replenishment medications and of the first and secondcells in the memory of the external device.

In an embodiment, the method further includes the steps of opening thedoor of the first or second cell; scanning a code on an inside of thedoor; and verifying that the code on the inside of the door is thecorrect code associated with the first cell.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features and advantages of the invention will becomemore readily appreciated when considered in connection with thefollowing description of the presently preferred embodiments, appendedclaims and accompanying drawings, in which:

FIG. 1 is a block diagram of an example system according to an exampleembodiment;

FIG. 2 is a block diagram of an example order processing device that maybe deployed within the system of FIG. 1 ;

FIG. 3 is a perspective elevation view of a pallet containing aplurality of containers;

FIG. 4 is a perspective elevation view of a unit of use device that maybe deployed within the system of FIG. 1 ;

FIG. 5 is a front elevation view of the unit of use device of FIG. 4 ;

FIG. 6 is a side elevation view of the unit of use device of FIG. 4 ;

FIG. 7 is a schematic view illustrating a medical verification system;

FIG. 8 is a flow chart illustrating the steps pertaining to a technicianin a medical verification process;

FIG. 9 is a perspective view showing a technician device scanning acontainer;

FIG. 10 illustrates a first graphical user interface;

FIG. 11 also illustrates the first graphical user interface after anadditional picture has been taken;

FIG. 12 is a flow chart illustrating the steps pertaining to apharmacist in the medical verification process;

FIG. 13 illustrates a second graphical user interface;

FIG. 14 illustrates a third graphical user interface; and

FIGS. 15A and 15B combine to show another flow chart illustrating thesteps in a medical verification process.

DETAILED DESCRIPTION OF THE ENABLING EMBODIMENTS

At times, handling medication units must be verified by a licensedpharmacist, e.g., using an electronic device associated with thepharmacist. In many instances, a pharmacist who has expert knowledge ofthe medications must personally verify all medications before they areloaded into the respective cells of the high volume filler. For example,in a high volume filler, the pharmacist must physically be present atthe high volume filler and manually unlock a cell with a prior to addingmedications to that cell. The present disclosure provides systems andmethods for a pharmacist to remotely or virtually verify drug fill via adisplay on a monitor remote from the container with the drug fill.

FIG. 1 is a block diagram of an example implementation of a system 100,according to an example embodiment. While the system 100 is generallydescribed as being deployed in a high volume pharmacy or fulfillmentcenter (e.g., a mail order pharmacy, a direct delivery pharmacy, anautomated pharmacy, multiple package delivering center, and the like),the system 100 and/or components thereof may otherwise be deployed(e.g., in a lower volume pharmacy). A high volume pharmacy may be apharmacy that is capable of filling prescriptions automatically,mechanically, manually, or a combination thereof. The system 100 mayinclude a benefit manager device 102, a pharmacy device 106, and a userdevice 108, which may communicate with each other directly and/or over anetwork 104. The system may also include a storage device 110.

The benefit manager 102 is a device operated by an entity that is atleast partially responsible for creation and/or management of thepharmacy or drug benefit. While such an entity operating the benefitmanager device 102 is typically a pharmacy benefit manager (PBM), otherentities may operate the benefit manager device 102 either on behalf ofthemselves, the PBM, another entity, or other entities. For example, thebenefit manager device 102 may be operated by a health plan, a retailpharmacy chain, a drug wholesaler, a data analytics or other type ofsoftware-related company, or the like. In some embodiments, a PBM thatprovides the pharmacy benefit may also provide one or more than oneadditional benefits including a medical or health benefit, a dentalbenefit, a vision benefit, a wellness benefit, a radiology benefit, apet care benefit, an insurance benefit, a long term care benefit, anursing home benefit, and the like. The PBM may, in addition to its PBMoperations, operate one or more than one pharmacy. The pharmaceuticalvending machines or kiosks, and the like.

Some of the operations of the PBM that operates the benefit managerdevice 102 may include the following activities and processes. A member(or a person on behalf of the member) of a pharmacy benefit planadministered by or through the PBM attempts to obtain a prescriptiondrug at a retail pharmacy location (e.g., a location of a physicalstore) from a pharmacist or a pharmacist technician. The member may alsoattempt to obtain the prescription drug through mail order drug deliveryfrom a mail order pharmacy location, which may be the high volumepharmacy system 100. In some embodiments, the member may also attempt toobtain the prescription drug directly or indirectly through the use of amachine, such as a kiosk, vending unit, mobile electronic device, or adifferent type of mechanical electrical, electronic communicationdevice, and/or computing device. Such a machine may be filled with theprescription drug in prescription packaging, which may include multipleprescription components, by the high volume pharmacy system 100.

The member may have a copayment for the prescription drug that reflectsan amount of money that the member is responsible to pay the pharmacyfor the prescription drug. The money paid by the member to the pharmacymay come from personal funds of the member, a health savings account(HAS) of the member or the member's family, a health reimbursementarrangement (HRA) of the member or the member's family, a flexiblespending account (FSA) of the member or the member's family, or thelike. In some instances, an employer of the member may directly orindirectly fund or reimburse the member for the copayments.

The amount of the co-pay required form the member may vary withdifferent pharmacy benefit plans having different plan sponsors orclients and/or prescription drugs. The member's copayment may be basedon a flat copayment (e.g., $10), co-insurance (e.g., 10%), and/or adeductible (e.g., for first $500 of annual prescription drug expenses)for certain prescription drugs, certain types and/or classes ofprescription drugs, and/or all prescription drugs. The copayment may bestored in the storage 110 or determined by the benefit manager device102.

In some instances, the member may not pay the copayment or may only paya portion of the copayment for the prescription drug. For example, ifthe usual and customary cost for a generic version of a prescriptiondrug is $4, and the member's flat copayment is $20 for the prescriptiondrug, the member may only be required to pay $4 to receive theprescription drug. In another example involving a worker's compensationclaim. No copayment may be due by the member for the prescription drug.

In addition, copayments may also vary based on different deliverychannels used for the prescription drug to be received by the member.For example, the copayment for receiving the prescription drug from amail order pharmacy location may be less than the copayment forreceiving the prescription drug from a retail pharmacy location.

In conjunction with receiving the copayment (if any) from the member anddispensing the prescription drug to the member, the pharmacy submits aclaim to the PBM for the prescription drug. After receiving the PBM(e.g., through the benefit manager device 102) may perform certainadjudication operations including verifying eligibility of the member,identifying and/or reviewing an applicable formulary for the member todetermine any appropriate copayment, coinsurance, and deductible for theprescription drug, and performing a drug utilization review (DUR) on themember. The PBM provides a response to the pharmacy (e.g., from thebenefit manager device 102 to the pharmacy device 106) followingperformance of at least some of the aforementioned operations.

As part of the adjudication, a plan sponsor (or the PBM on behalf of theplan sponsor) ultimately reimburses the pharmacy for filling theprescription drug when the prescription drug was successfullyadjudicated.

The aforementioned adjudication operations generally occur before thecopayment is received and the prescription drug is dispensed. However,in some instances these operations may occur simultaneously,substantially simultaneously, or in a different order. In addition, moreor less adjudication operations may be performed as at least part of theadjudication process.

The amount of reimbursement paid to the pharmacy by a plan sponsorand/or money paid by the member may be determined at least partiallybased on the type(s) of pharmacy network in which the pharmacy isincluded. Other factors may also be used to determine the amount inaddition to the type of pharmacy network. For example, if the memberpays the pharmacy for the prescription drug without the prescriptiondrug benefit provided by the PBM (e.g., by paying cash without use ofthe prescription drug benefit or by use of a so-called pharmacy discountcard offering other negotiated rates), the amount of money paid by themember may be different than when the member uses prescription or drugbenefit. In some embodiments, the amount of money received by thepharmacy for dispensing the prescription drug and for the prescriptiondrug itself may be higher than when the member uses the prescription ordrug benefit. Some or all of the foregoing operations may be performedby executing instructions stored on the benefit manager device 102and/or an additional device.

Examples of the network 104 include Mobile Communications (GSM) network,a code division multiple access (CDMA) network, 3^(rd) GenerationPartnership Project (3GPP), an Internet Protocol (IP) network, aWireless Application Protocol (WAP) network, a WiFi network, or an IEEE802.11 standards network, as well as various combinations thereof. Thenetwork 104 may include an optical network. The network 104 may be alocal area network or a global communication network, such as theInternet. In some embodiments, the network 104 may include a networkdedicated to prescription e-orders, e.g., a prescribing network such asthe electronic prescribing network operated by Surescripts of Arlington,Va.

Moreover, although the system shows a single network 104, multiplenetworks can be used. The multiple networks may communicate in serieswith each other to link the devices 102, 106-110 or in parallel to linkthe devices 102, 106-110.

The pharmacy device 106 may include an order processing device 114, apharmacy manager device 116, and a pharmacy fulfillment device 112 incommunication with each other directly and/or over the network 104.

The order processing device 114 may receive information regardingfilling prescriptions and may direct an order component to one or morethan one of the devices of the pharmacy fulfillment device 112 at apharmacy. The pharmacy fulfillment device 112 may fulfill, dispense,aggregate, and/or pack the order components of the prescription drugs inaccordance with one or more than one of the prescription orders directedby the order processing device 114. The order processing device 114 maybe deployed in the system 100, or may otherwise be used.

In general, the order processing device 114 is a device located withinor otherwise associated with the pharmacy to enable fulfillment of aprescription and dispensing prescription drugs by the pharmacyfulfilment device 112. In some embodiments, the order processing device114 may be an external device separate from the pharmacy and communicatewith other devices located within the pharmacy.

For example, the external order processing device 114 may communicatewith an internal order processing device 114 and/or other deviceslocated within the system 100. In some embodiments, the external orderprocessing device 114 may have limited functionality (e.g., as operatedby a patient requesting fulfillment of a prescription drug), while theinternal pharmacy order processing device 114 may have greaterfunctionality (e.g., as operated by a pharmacist).

The order processing device 114 may track the prescription order as itis fulfilled by the pharmacy fulfillment device 112. The prescriptionorder may include one or more than one prescription drugs to be filledby the pharmacy. The order processing device 114 may make pharmacyrouting decisions and/or order consolidation decisions for theparticular prescription order. The pharmacy routing decisions mayinclude what device(s) in the pharmacy are responsible for filling orotherwise handling certain portions of the prescription order. The orderconsolidation decisions include whether portions of one prescriptionorder or multiple prescription orders should be shipped together for apatient or a patient family. The order processing device 114 may alsotrack and/or schedule literature or paperwork associated with eachprescription order or multiple prescription orders that are beingshipped together.

The pharmacy management device 116 may enable and/or facilitatemanagement and operations in a pharmacy. For example, the pharmacymanagement device 116 may provide functionality to enable receipt andprocessing of prescription drug claims, management of pharmacypersonnel, management of pharmaceutical and non-pharmaceutical products,track products in the pharmacy, record workplace incidents involvepersonnel and products, and the like. In some embodiments, the orderprocessing device 114 may operate in combination with the pharmacymanagement device 116.

In some embodiments, the pharmacy management device 116 may be a deviceassociated with a retail pharmacy location (e.g., exclusive pharmacylocation, a grocery store with a retail pharmacy, or a general salesstore with a retail pharmacy) or other type of pharmacy location atwhich a member attempts to obtain a prescription. The pharmacymanagement device 116 may be utilized by the pharmacy to submit theclaim to the PBM (e.g., through the benefit management device 102) foradjudication.

In some embodiments, the pharmacy management device 116 may enableinformation exchange between the pharmacy and the PBM, for example, toallow the sharing of member information such as drug history, and thelike, that may allow the pharmacy to better service a member (e.g., byproviding more informed therapy consultation and drug interactioninformation, etc.). In some embodiments, the benefit manager 102 maytrack prescription drug fulfillment and/or other information forpatients that are not members or have not identified themselves asmembers, at the time (or in conjunction with the time) in which theyseek to have a prescription filled at a pharmacy.

The pharmacy fulfillment devices 112, the order processing device,and/or the pharmacy management device 116 may include circuitry, aprocessor, a memory to store data and instructions, and communicationfunctionality. These devices 112-116, in some embodiments are dedicatedto performing processes, methods and/or instructions described herein.Other types of electronic devices specifically configured to implementwith the processes, methods and/or instructions described herein mayalso be used.

In some embodiments, at least some functionality of the order processingdevice 114 may be included in the pharmacy management device 116 mayinclude circuitry, a processor, a memory to store data and instructions,and communication functionality. These devices 112-116, in someembodiments, are dedicated to performing processes, methods and/orinstructions described herein. Other types of electronic devicesspecifically configured to implement with the processes, methods and/orinstructions described herein may also be used.

In some embodiments, at least some functionality of the order processingdevice 114 may be included in the pharmacy management device 116. Theorder processing device 114 may be in a client-server relationship withthe pharmacy management device 116, in a peer-to-peer relationship withthe pharmacy management device 116, or in a different type ofrelationship with the pharmacy management device 116. The orderprocessing device 114 and/or the pharmacy management device 116 maycommunicate directly (e.g., by utilizing a local storage) and/or throughthe network 104 (e.g., by utilizing a cloud configuration or software asa service, etc.) with the storage 110.

The user device 108 is used by a device operator. The device operatormay be a user (e.g., an employee, a contractor, a benefit member, apatient of the pharmacy, or the like) associated with the system 100.Other device operators may also operate the user device 108. In someembodiments, the user device 108 may enable the device operator toattend to pharmacy operations in a convenient manner (e.g., remote froma pharmacy). In some embodiments, the user device 108 may enable thedevice operator to receive information about pharmacy processes,prescription drug fulfillment status, and the like.

The user device 108 may be a stand-alone device that solely provides atleast some of the functionality of the methods and systems, or may be amulti-use device that has functionality outside off analysis of themethods and systems. Examples of the user device 108 include a set-topbox (STB), a receiver card, a mobile telephone, a personal digitalassistant (PDA), a display device, a portable gaming unit, a computingsystem, and the like. Other devices, however, may also be used. In someembodiments, the computing system may include a mobile computing device.For example, the user device 108 may include a mobile electronic device,such as an iPhone or iPad by Apple, Inc., and mobile electronic devicespowered by Android by Google, Inc. The user device 108 may also includeother computing devices, such as desktop computing devices, notebookcomputing devices, netbook computing devices, gaming devices, and thelike. Other types of electronic devices may also be used.

The storage device 110 may include: a non-transitory storage (e.g.,memory, hard disk, CD-ROM, and the like) in communication with thebenefit manager device 102, the pharmacy device 106, and/or the userdevice 108 directly and/or over the network 104. The non-transitorystorage may store order data 118, member 120, claims data 122, drug data124, prescription data 126, and/or plan sponsor 128. Further, the system100 may include additional devices, which may communicate with eachother directly or over the network 104.

The order data 118 may be related to a prescription order. The orderdata may include the type of the prescription drug (e.g., drug name andstrength) and quantity of the prescription drug. The order data 118 mayalso include data used for completion of the prescription, such asprescription materials and/or the type and/or size of container in whichthe drug is dispensed or in which is requested to be dispensed. Ingeneral, prescription materials include an electronic copy ofinformation regarding the prescription drug for inclusion with orotherwise provided (e.g., via email) in conjunction with the fulfilledprescription. The prescription materials may include electronicinformation regarding drug interaction warnings, recommended usagepossible side effects, expiration date, date of prescribing, or thelike. The order data 118 may be used by the pharmacy to fulfill apharmacy order.

In some embodiments, the order data 118 includes verificationinformation associated with fulfillment of the prescription in thepharmacy. For example, the order data 118 may include videos and/orimages taken of (i) the prescription drug prior to dispensing, duringdispensing, and/or after dispensing, (ii) the prescription container(e.g., a prescription bottle and sealing lid, prescription packaging,and the like) used to contain the prescription drug prior to dispensing,during dispensing, and/or after dispensing, (iii) the packaging and/orpackaging materials used to ship or otherwise deliver the prescriptiondrug prior to dispensing, during dispensing, and/or after dispensing,and/or (iv) the fulfillment process within the pharmacy. Other types ofverification information, such as bar code data read from pallets, bins,trays, carts, and the like used to facilitate transportation ofprescriptions within the pharmacy may also be stored as order data 118.

The member data 120 includes information regarding the membersassociated with the PBM. The information stored as member data 120 mayinclude personal information, personal health information, protectedhealth information, fitness data, health data, web and mobile appactivity, and the like. Examples of the member data 120 include name,address, telephone number, e-mail address, prescription drug history,and the like. The member data 120 may include a plan sponsor identifierthat identifies the plan sponsor associated with the member and/or amember identifier that identifies the member to the plan sponsor. Themember data 120 may also include, by way of example, dispensationpreferences such as type of label, type of cap, message preferences,language preferences, or the like.

The member data 120 may be accessed by various devices in the pharmacyto obtain information utilized for fulfillment and shipping ofprescription orders. In some embodiments, an external order processingdevice 114 operated by or on behalf of a member may have access to atleast a portion of the member data 120 for review, verification, orother purposes.

In some embodiments, the member data 120 may include information forpersons who are patients of the pharmacy but are not members in apharmacy benefit plan being provided by the PBM. For example, thesepatients may obtain drugs directly from the pharmacy, through a privatelabel service offered by the pharmacy, or otherwise. In general, the useof the terms member (e.g., of a prescription drug benefit plan) andpatient (e.g., of a pharmacy) may be used interchangeably in thisdisclosure.

The claims data 122 includes information regarding pharmacy claimsadjusted by the PBM under a drug benefit program provided by the PBM forone, or more than one, plan sponsor. In general, the claims data 122includes an identification of the client that sponsors the drug benefitprogram under which the claim is made, and/or the member that purchasedthe prescription drug giving rise to the claim, the prescription drugthat was filled by the pharmacy (e.g., the national drug code number),the dispensing date, generic indicator, GPI number, medication class,the cost of the prescription drug provided under the drug benefitprogram, the copay/coinsurance amount, rebate information, and/or membereligibility, and the like. Additional information may be included.

In some embodiments, other types of claims beyond prescription drugclaims may be stored in the claims data 122. For example, medicalclaims, dental claims, wellness claims, or other types of healthcare-related claims for members may be stored as a portion of the claimsdata.

In some embodiments, the claims data 122 includes claims that identifythe members with whom the claims are associated. In some embodiments,the claims data 122 includes claims that have been de-identified (e.g.,associated with a unique identifier but not with a particular,identifiable member), aggregated, and/or otherwise processed.

The drug data 124 may include drug name (e.g., technical name and/orcommon name), other names by which the drug is known by, activeingredients, an image of the drug (e.g., in pill form), and the like.The drug data 124 may include information associated with a singlemedication or multiple medications.

The prescription data 126 may include information regardingprescriptions that may be issued by prescribers on behalf of patients,who may be members of the pharmacy benefit plan, for example to befilled by a pharmacy. Examples of the prescription data 126 includepatient names, medication or treatment (such as lab tests), dosinginformation, and the like. The prescriptions may be electronicprescriptions, paper prescriptions that have been scanned, or otherwise.In some embodiments, the dosing information reflects a frequency of use(e.g., once a day, twice a day, before each meal, etc.) and a durationof use (e.g., a few days, a week, a few weeks, a month, etc.).

In some embodiments, the order data 118 may be linked to associatedmember data 120, claims data 122, drug data 124, and/or prescriptiondata 126.

The plan sponsor data 128 includes information regarding the plansponsors of the PBM. Examples of the plan sponsor data 128 includecompany name, company address, contact name, contact telephone number,contact e-mail address, and the like.

FIG. 2 illustrates the pharmacy fulfillment device 112, according to anexample embodiment. The pharmacy fulfillment device 112 may be used toprocess and fulfill prescriptions and prescription orders. Afterfulfillment, the fulfilled prescriptions are packed for shipping.

The pharmacy fulfillment device 112 may include devices in communicationwith the benefit manager device, the order processing device 114, and/orthe non-transitory storage 110, directly or over the network 104.Specifically, the pharmacy fulfillment device 112 may include palletsizing and pucking device(s); loading device(s) 208; inspect device(s)210, unit of use device(s) 212, automated dispensing device(s) 214,manual fulfillment device(s) 214, review device(s) 218, imagingdevice(s) 220, cap device(s) 222, accumulation device(s) 224, literaturedevice(s) 228, packing device(s) 226, and unit of use packing device(s)230. Further, the pharmacy fulfillment device 112 may include additionaldevices, which may communicate with each other directly or over thenetwork 104.

In some embodiments, operations performed by one or more of thesedevices 206-230 may be performed sequentially, or in parallel with theoperations of devices as may be coordinated by the order processingdevice 114. In some embodiments, the order processing device 114 tracksa prescription with the pharmacy based on operations performed by one ormore than one of the devices 206-230.

In some embodiments, the pharmacy fulfillment device 112 may transportprescription drug containers, for example, between more than one of thedevices 206-230 in a high volume fulfillment center, by use of pallets.The pallet sizing and pucking device 206 may configure pucks in apallet. A pallet may be a transport structure for a number ofprescription containers, and may include a number of cavities. A puckmay be placed in one or more than one of the cavities in a pallet by thepallet sizing and pucking device 206. The puck may include a receptaclesized and shaped to receive a prescription container. Such containersmay be supported by the pucks during carriage in the pallet. Differentpucks may have differently sized and shaped receptacles to accommodatecontainers of differing sizes, as may be appropriate for differentprescriptions.

The arrangement of pucks in a pallet may be determined by the orderprocessing device 114 based on prescriptions that the order processingdevice 114 decides to launch. The arrangement logic may be implementeddirectly in the pallet sizing and pucking device 206. Once aprescription is set to be launched, a puck suitable for the appropriatesize of container for that prescription may be positioned in a pallet bya robotic arm or pickers. The pallet sizing and pucking device 206 maylaunch a pallet once pucks have been configured in the pallet.

The loading device 208 may load prescription containers into the puckson a pallet by a robotic arm, a pick and place mechanism, or the like.In one embodiment, the loading device 208 has robotic arms or pickers tograsp a prescription container and move it to and from a pallet or toand from a puck. The loading device may also print a label that isappropriate for a container that is to be loaded onto the pallet andapply the label to the container. The pallet may be located on aconveyor assembly during these operations (e.g., at the high volumefulfillment center or the like).

The inspect device 210 may verify that containers in a pallet arecorrectly labeled and in the correct spot on the pallet. The inspectdevice 210 may scan the label on one or more than one container on thepallet. Labels of containers may be scanned or imaged in full or in partby the inspect device 210. Such imaging may occur after the containerhas been lifted out of its puck by a robotic arm, picker, or the like,or may be otherwise scanned or imaged while retained in the puck. Insome embodiments, images and/or video captured by the inspect device maybe stored in the storage device as a portion of the order data 118.

The unit of use device 212 may temporarily store, monitor, label, and/ordispense unit of use products. In general, unit of use products areprescription drug products that may be delivered to a patient or memberwithout being repackaged at the pharmacy. These products may includepills in a container, pills in a blister pack, inhalers, liquids in aspray or other dispensing container, and the like. Prescription drugproducts dispensed by the unit of use device 212 may be packagedindividually or collectively for shipping, or may be shipped incombination with other prescription drugs dispensed by other devices(e.g., in the high volume fulfillment center).

At least some of the operations of the devices 206-230 may be directedby the other processing device 114. For example, the manual fulfillmentdevice 216, the review device 218, the automated dispensing device 214,the packing device 226, and/or another device may receive instructionsprovided by the order processing device.

The automated dispensing device 214 may include one or more than onedevice that dispenses prescription drugs or pharmaceuticals intoprescription containers in accordance with one or multiple prescriptionorders. In general, the automated dispensing device 214 may includemechanical and electronic components with, in some embodiments, softwareand/or logic to facilitate pharmaceutical dispensing that wouldotherwise be performed in a manual fashion by a pharmacist and/orpharmacist technician. For example, the automated dispensing device 214may include high volume fillers (HVFs) that fill a number ofprescription drug types at a rapid rate and blister pack machines thatdispense and pack drugs into a blister pack. Prescription drugsdispensed by the automated dispensing devices 214 may be packagedindividually or collectively for shipping, or may be shipped incombination with other prescription drugs dispensed by other devices inthe high volume fulfillment center.

The manual fulfillment device 216 may provide for manual fulfillment ofprescriptions. For example, the manual fulfillment device 216 mayreceive or obtain a container and enable fulfillment of the container bya pharmacist or pharmacy technician. In some embodiments, the manualfulfillment device 216 provides the filled container to another devicein the pharmacy fulfillment devices 112 to be joined with othercontainers in a prescription order for a patient or member. In general,a manual fulfillment may include operations at least partially performedby a pharmacist or a pharmacy technician. For example, a person mayretrieve a supply of the prescribed drug, may make an observation, maycount out a prescribed quantity of drugs and place them into aprescription container, or the like. Some portions of the manualfulfillment process may be automated by use of a machine. For example,counting of capsules, tablets, or pills may be at least partiallyautomated (e.g., through use of a pill counter or the like).Prescription drugs dispensed by the manual fulfillment device 216 may bepackaged individually or collectively for shipping or may be shipped incombination with other prescription drugs dispensed by other devices inthe high volume fulfillment center.

The review device 218 may process prescription containers to be reviewedby a pharmacist for proper pill count, exception handling, prescriptionverification, and the like. Fulfilled prescriptions may be manuallyreviewed and/or verified by a pharmacist, as may be required by state orlocal law. A pharmacist or other licensed pharmacy person who maydispense certain drugs in compliance with local and/or other laws mayoperate the review device 218 and visually inspect a prescriptioncontainer that has been filled with a prescription drug. The pharmacistmay review, verify, and/or evaluate drug quantity, drug strength, and/ordrug interaction concerns, or otherwise perform pharmacist services. Thepharmacist may also handle containers which have been flagged as anexception, such as containers with unreadable labels, containers forwhich the associated prescription order has been cancelled, containerswith defects, and the like. In an example embodiment, the manual reviewmay be performed at the manual station.

The imaging device 220 may image containers prior to filling and/orafter they have been filled with pharmaceuticals. The imaging device 220may measure a fill height of the pharmaceuticals in the container basedon the obtained image to determine if the container is filled to thecorrect height given the type of pharmaceutical and the number of pillsin the prescription. Images of the pills in the container may also beobtained to detect the size of the pills themselves and markingsthereon. The images may be transmitted to the order processing device114, and/or stored in the storage device 110 as part of the order data118.

The cap device 222 may be used to cap or otherwise seal a prescriptioncontainer. In some embodiments, the cap device 222 may secure aprescription container with a type of cap in accordance with a patientpreference (e.g., a preference regarding child resistance, a preferenceregarding built-in adherence functionality, or the like), a plan sponsorpreference, a prescriber preference, or the like. The cap device 222 mayalso etch a message into the cap or otherwise associate a message intothe cap, although this process may be performed by a different device inthe high volume fulfillment center.

The accumulation device 224 accumulates various containers ofprescription devices in a prescription order. The accumulation device224 may accumulate prescription containers from various devices or areasof the pharmacy. For example, the accumulation device 224 may accumulateprescription containers from the unit of use device 212, the automateddispensing device 214, the manual fulfillment device 216, and the reviewdevice 218, at the high volume fulfillment center. The accumulationdevice 224 may be used to group the prescription containers prior toshipment to the member or otherwise.

The literature device 228 prints, or otherwise generates, literature toinclude with prescription drug orders. The literature may be printed onmultiple sheets of substrates, such as paper, coated paper, printablepolymers, or combinations thereof. The literature printed by theliterature device 228 may include information required to accompany theprescription drugs included in a prescription order, relating toprescription drugs in the order, financial information associated withthe order (e.g., an invoice or an account statement, or the like).

In some embodiments, the literature device 228 folds or otherwiseprepares the literature for inclusion with a prescription drug order(e.g., in a shipping container or the like). In some embodiments, theliterature device 228 that prints the literature may be separate fromthe literature device that prepares the literature for inclusion with aprescription order. The packing device 226 packages a prescription orderin preparation for shipping the order. The packing device 226 may box,bag, or otherwise package the fulfilled prescription order for delivery.The packing device 226 may be a wrap seal device. A wrap seal devicedeployed as the packing device 226 may be a wrap seal device. A wrapseal device deployed as the packing device 226 may pause before anindex; during the pause, one or more bottle, envelope or literatureitems have been placed within a vacuum pocket of the wrap seal device.After any bottle, envelope, or literature items have been placed in thepocket, the wrap seal device may index; specifically, the vacuum pocketmay move forward. In an example embodiment, the forward movement isabout the length of a bag (for example, between about 16 and 20 inches).

The packing device 226 may further place inserts (e.g., literature orother papers) into the packaging received from the literature device 228or otherwise. For example, bulk prescription orders may be shipped in abox, while other prescription orders may be shipped in a bag, which maybe a wrap seal bag. The packing device 226 may label the box or bag withan address and a recipient's name. The label may be printed and affixedto the bag or box, be printed directly onto the bag or box, or otherwiseassociated with the bag or box. The packing device 226 may sort the boxor bag for mailing in an efficient manner (e.g., sort by deliveryaddress, sort by zip code, or the like). The packing device 226 maylabel the box or bag with an address and a recipient's name. The labelmay be printed and affixed to the bag or box, be printed directly ontothe bag or box, or otherwise associated with the bag or box. The packingdevice 226 may sort the box or bag for mailing in an efficient manner(e.g., sort by delivery address, sort by zip code, or the like). Thepacking device 226 may include ice or temperature sensitive elements forprescriptions which are to be kept within a temperature range duringshipping in order to retain efficacy or otherwise. The ultimate packagemay then be shipped through postal mail, through a mail order deliveryservice that ships via ground and/or air (e.g., UPS®, FedEx®, or DHL®,or the like), through delivery service, through a local delivery service(e.g., a courier service), through a locker box at a shipping site(e.g., an Amazon® locker, library locker, a post office box, or thelike) or otherwise.

The unit of use packing device 230 packages a unit of use prescriptionorder in preparation for shipping the order.

The pharmacy fulfillment device 112 in FIG. 2 may include single devices206-230 or multiple devices 206-230 (e.g., depending upon implementationin a pharmacy). The devices 206-230 may be the same type or model ofdevice or may be different device types or models. When multiple devicesare present, the multiple devices may be of the same device type ormodels or may be a different device type or model. The types of devices206-230 shown in FIG. 2 are example devices. In other configurations ofthe system 100, lesser, additional, or different types of devices may beincluded.

Moreover, multiple devices may share processing and/or memory resources.The devices 206-230 may be located in the same area or in differentlocations. For example, the devices 206-230 may be located in a buildingor a set of adjoining buildings. The devices 206-230 may beinterconnected (e.g., by conveyors), networked, and/or otherwise incontact with one another or integrated with one another (e.g., at thehigh volume fulfillment center). In addition, the functionality of adevice may be split among a number of discrete devices and/or combinedwith other devices.

FIG. 3 illustrates a pallet 302, according to an example embodiment,which may be used in the pharmacy fulfillment device 112 of the system100 of FIG. 1 . The pallet 302 may be a transport structure for a numberof prescription containers 304, and may include a number of cavities306. While the pallet 302 is shown to include 25 cavities in a five byfive cavity row/column configuration, other numbers of categories and/orcavity configurations of varying shapes, sizes, and/or dimensions may beused. In some embodiments, the pallet 302 may be substantially squareand, in such an embodiment, have a width and length of betweenapproximately 18 inches and 22 inches (e.g., approximately 18 inches, 19inches, 20 inches, 21 inches, or 22 inches). In some embodiments, thewidth and/or length may be greater than approximately 22 inches or lessthan approximately 18 inches.

In an example embodiment, the cavities 306 are spaced on the pallet 302such that the center point of adjacent cavities 306 is approximately 3and 4 inches (e.g., approximately 3 inches, 3.25 inches, 3.5 inches,3.75 inches, or 4 inches). In another example embodiment, the distancebetween center points of adjacent cavities 306 is more thanapproximately 4 inches. In yet another example embodiment, the centerpoints of cavities 306 are less than approximately 3 inches apart.

The pallet 302 may be made in whole or in part of metal, such asaluminum. Other suitable materials may be used for the pallet 302, suchas plastic. The pallet 302 may be rigid so that the cavities remain in aknown location that can be tracked while the pallet 302 moves throughthe system 100. The pallet 302 may include bumpers.

In some embodiments, other carriers beyond the pallet 302 and/or nocarrier may be used to move containers or groups of containers throughthe system 100.

The pallet 302 may retain one or more than one container 304. Acontainer 304 is generally cylindrical and may be one or a variety ofsizes utilized by a pharmacy for fulfillment of a prescription. Forexample, a pharmacy may have two different sized containers or threedifferent sized containers. Any number of different sized containers maybe used with the pallet 302. While the container 304 is generallydenoted as being used with the pallet 302, the containers 304 mayotherwise be used in the system 100 or in a different system. Shapesbeyond cylindrical shapes may be used for the containers 304. Examplesof other shapes include regular prisms, elliptical cylinders, andcombinations thereof. The receptacle of a puck may be sized to receiveand support the outer shape of the container. The containers 304 may bedisposed in the pallet 302 such that they are close to one another butdo not touch.

The pallet 302 may include a radio-frequency identification (RFID) tag308. The RFID tag 308 may be an active RFID tag, such as an active RFIDtag with a close reading range. In some embodiments, the RFID tag 308 isan active, narrowband, read/write RFID tag.

The RFID tag 308 of a particular pallet 302 may store data (or otherwisefacilitate the access of data, e.g., from the database 108) associatedwith the containers 304 that have been, are, and/or will be placedwithin the pallet 302, such as the order data, the claims data, the drugdata, the prescription data, and/or the plan sponsor data associatedwith such containers. Other data may be stored by and/or associated withthe RFID tag 314, such as the age of the pallet 302, the number of timesthe pallet 302 has been used to transport containers 304 through thesystem 100, the number of errors associated with the pallet 302, and thelike. The RFID tag 314 may also store the position of individualcontainers on the pallet 302. In an example embodiment, the RFID tag 308of the pallet 302, while deployed within an automated dispensing device212, stores data associated with one or more of the following datafields: (1) container identifiers, (2) identifier of the particularautomated dispensing device 212, (3) identifiers of the particular cellsfrom which a particular container will be filled (as described below),(4) container properties (e.g., the status of containers 304 on thepallet 302, such as whether the containers 304 have passed an inspectionstation and have been identified as containers 304 to be filled in theparticular automated dispensing device 212), and (5) the pallet routewithin the automated dispensing device 212.

The pucks 310 may be used to modify the size of the cavities 306 toallow the pallet 302 to accommodate different sizes of the containers304.

FIG. 4 illustrates the automated dispensing device 212, according to anexample embodiment. The automated dispensing device 212 enablesdispensing of a number of different types of pharmaceuticals in anautomated or semiautomatic manner. The automated dispensing device 212includes a filling cabinet 402, a prefill assembly 404, and a palletsystem 406, which includes a pallet conveyor 408. The filling cabinet402 stores pharmaceuticals to be dispensed into containers via theprefill assembly 404 and dispenses measured quantities ofpharmaceuticals into the prefill assembly 404. The prefill assembly 404stores the measured quantities of medications 1000 (shown in FIG. 10 )and dispenses the measured quantities of medications 1000 received fromthe filling cabinet 402 into containers 304 on the pallet 302 while thepallet 302 is positioned in the pallet system 406. The pallet conveyor408 can transport the pallets through some or all of the devices withinthe pharmacy fulfillment device 112 (shown in FIG. 2 ).

As discussed in further detail below, in operation, the pallet conveyor408 automatically brings a pallet 302 (shown in FIG. 3 ) with one ormore containers 304 to the pallet system 406. The pallet system 406automatically guides the pallet 302 to a location directly beneath theprefill assembly 404 so that the measured quantity of medications 1000(shown in FIG. 10 ) can be dispensed into one of the containers 304found on the pallet 302. This process can be repeated to dispensemultiple measured quantities of the same or different medications 1000into different containers 304 on the pallet 302. The pallet conveyor 408may be a chain conveyor or a belt driven conveyor, e.g., a belted BoschTS2 belt-driven conveyor. In some embodiments, the pallet conveyor 408is a low friction, high-speed conveyor. Although pallets 302 aregenerally described herein as employed to move a group of containers 304through the system 100 or within the automated dispensing device 212,trays or other types of carriers and any suitable type of containermanagement system may be employed to individually or as a group move thecontainers 304 through the system 100 or within the automated dispensingdevice 212.

In the exemplary embodiment, the filling cabinet 402 is physicallyadjacent to the prefill assembly 404, and the prefill assembly 404 isphysically located directly above the pallet system 406. For example,the filling cabinet 402 and prefill assembly 404 may be located on asecond floor (e.g., in a building), and the pallet system 406 may belocated on a second floor below the first. These components of theautomated dispensing device 212 may be otherwise positioned, e.g., in aposition to utilize gravity to move medications 1000 from the fillingcabinet 402 to the prefill assembly 404 and then to the containers 304on the pallet 302. For example, some portion of the filling cabinet 402may extend below the first floor.

In the exemplary embodiment, the filling cabinet 402 includes multiplecells 412 arranged in a grid-like pattern with a plurality of columnsand a plurality of rows. Specifically, in the exemplary embodiment, thefilling cabinet 402 has ten columns and nine rows for a total of ninetycells 412. In some embodiments, the filling cabinet 402 has either moreor fewer rows and/or columns of cells 412. The various cells 412 mayeach be adapted to similar or different solid medications 1000 (shown inFIG. 10 ), e.g., pills, tablets, or capsules. For example, in someembodiments, a commonly prescribed medication 1000 may occupy more thanone cell 412. The cells 412 are be adapted to receive inserts 414, whichcan hold the medications 1000 then automatically dispense themedications 1000 into the prefill assembly 404. In the exemplaryembodiment, at least some inserts 416 may be permanently located in thecells 412 (other cells may include inserts that can pull out likedrawers). In the exemplary embodiment, only a single filling cabinet 402with a single prefill assembly 404 is shown. However, in someembodiments, two opposing filing cabinets 402 and two opposing prefillassemblies 404 may be positioned over the same pallet system 404.

As shown in FIG. 6 , each cell 412 has a pill counter with an output,which feeds the pharmaceuticals contained therein into the prefillassembly 404. The prefill assembly 404 includes a plurality of doors 416(one being shown), each of which includes a guiding system for guidingthe pharmaceuticals dispensed from the respective cells 412 into theappropriate containers 304 on the pallet 302 in the pallet system 406.The doors 416 can be slid horizontally away from the filling cabinet 402for maintenance either while the automated dispensing device 212 is inoperation or shut down. The filling cabinet 402 is configured such thatthe cell 412 will not dispense medications 1000 (shown in FIG. 10 ) whenthe door 416 aligned that cell 412 is out of position, such as duringmaintenance.

In the exemplary embodiment, each cell 412 has a face plate with a door416 which must be unlocked to open so that the insert 414 can be filledwith medications or so the insert 414 can be replaced with anotherinsert 414. The door 416 is configured to only unlock pursuant to amedication verification process that both mitigates risk of access tothe medications 1000 to unauthorized individuals and that mitigates therisks that improper and/or defective medications 1000 will be added tothe insert 414. The lock on the door 416 can be of any suitable typewhich can be remotely and electronically locked and unlocked, forexample, with an electronically activated solenoid.

The medication verification process utilizes at least one technician anda pharmacist. The technician is physically located at the automateddispensing device 212 with the filling cabinet 402 for physicallyrefilling the cells 412 with the medications 1000, and the pharmacistmay either be located at the automated dispensing device 212 or who maybe remote therefrom. In some embodiments, the automated filling device212 includes a plurality of filling cabinets 402 and a plurality oftechnicians with each technician being individually responsible for oneor more filling cabinets 402. In other embodiments, more than onetechnician may be responsible for the same filling cabinet 402. Asdiscussed in further detail below, during the medication verificationprocess, a number of checks must be passed before any medications 1000can be added to a cell 412, and to overcome those checks, the technicianand pharmacist work as a team while utilizing automatic technologicaltools to ensure that the cells 412 are only filled with the correctmedications 1000. The flow charts of FIGS. 8 and 12 illustrate thevarious steps of the refilling operation with FIG. 8 illustrating thesteps pertaining to the technician and FIG. 12 illustrating the stepspertaining to the pharmacist.

Referring now to FIGS. 4, 5, 7, and 10 , the technician has a techniciandevice 700; the pharmacist has a pharmacist device 702. The techniciandevice 700 and pharmacist device 702 are in communication with oneanother, with an external device 704 (such as a server), and with acontroller 706 in the automated dispensing device 212 via the internet708. In operation, the controller 706 continuously monitors thequantities of medications 1000 in the cells 412 of the various fillingcabinets 402 within the automated dispensing device 212 and also futuredemand for medications 1000 based on the types of medications to beadded to the containers 304 upstream of the automated dispensing device212. Based sends an alert to the technician device 700. When themedication count in one of the cells 412 falls below a predeterminedthreshold, the controller 706 automatically sends a notification signalto the technician device 700.

The technician device 700 is a portable unit, such as a handheld touchcomputer, a tablet computer, or smart glasses. The technician device 700includes a display screen 710, which may be, for example, a liquidcrystal display (LCD) type of screen or a light emitting diode (LED)type of screen. The technician device 700 also has an input means 712may include, for example, a touch screen, a stylus, a keyboard, amicrophone, and/or an external controller. The technician device 700further includes an imager 714, which could either be either a built-incamera or an external (for example, wearable) camera. The imager 714 canwhich communicates wirelessly with a base unit of the technician device700. The imager 714 can form visible images of a target location, e.g.,a part of an automated filling device. The imager 714 can form imagesusing radiation in the humanly visible spectrum e.g., red to blueradiation spectrum. In an example embodiment, the imager 714 can alsoform images in the non-visible spectrum. The non-visible spectrum can beconverted to a visible spectrum for display on a reviewer's device(e.g., a pharmacist display). The imager 714 can form the images and, inthe case of photographs, indirectly using an imaging integrated circuitand image processing circuitry, e.g., a DSP. The technician device 700also includes a processor 716, and a memory 718 operably coupled to theprocessor, and a portable power source 720, such as a battery or a fuelcell. The technician device 700 includes a wireless module 722, whichallows the technician device 700 to access wirelessly a globalcommunication network, e.g., the internet 708 and/or a local network. Insome embodiments, the wireless module 722 communicates with the internet708 via Wi-Fi protocols, Bluetooth® protocols, and/or a cellularnetwork. Other wireless protocols and systems may be used.

The pharmacist device 702 may be either portable or stationary, e.g., adesktop computer, a laptop computer, a handheld touch computer, a tabletcomputer, or smart glasses. The pharmacist device 702 includes a displayscreen 724 (such as an LCD or LED display) and includes at least oneinput means 726 (such as a touch screen, a keyboard, a mouse, a stylus,a microphone, etc.). The pharmacist device 702 includes either a wiredand/or wireless module 728, which allows the pharmacist device 702 toaccess the internet. In some embodiments, the wired or wireless module728 communicates with the internet and/or the local network via anEthernet cord, Bluetooth® protocols, and/or a cellular network. Thepharmacist device 702 also includes a processor 730 and a memory 732and, optionally, a power source.

The external device 704 is preferably a server that includes a processor734, a memory 736, and a wired and/or wireless module 738. In operation,all pictures and information processed by the technician and pharmacistdevices 700, 702 along with date and time stamps are saved on the memory736 of the external device 704 for a predetermined period of time toprovide an easily accessible record of all replenishments of themedications 1000 contained within the automated dispensing device 212.The external device 704 may be in the same location as the automateddispensing device 212 or may be located remote therefrom.

In an example embodiment, the external device 704 can perform an imagematching process to match the image received from the imager 714 on thetechnician device 700 to images corresponding to the medication loadedinto the automated filling machines. The images corresponding to themedication can be validated images stored in memory in the externaldevice 704. The external device 704 can automatically verify the imagefrom the imager, in an example embodiment, using imaging matchingschemes, e.g., template matching, feature matching, point featurematching, and the like, which can be run in the processing circuitry.The external device 704 can highlight on the image file any non-matchingelements in the image and send an altered (e.g., highlighted) version ofthe image file to the pharmacist device 702 for display thereon. Thehighlighted differences can operate to assist in calling attention tothe differences in the image when on the display.

As discussed in further detail below, in operation, the controller 706,the technician device 700, the pharmacist device 702, and the externaldevice 704 all communicate electronically with one another via theinternet 708 or a local network to ensure that the medications 1000 inthe automated dispensing device 212 are timely replenished so that thereis minimal (if any) delay in the dispensing of medications 1000 from theautomated dispensing device 212 into the containers 304 being movedthrough the automated dispensing device 212 by the pallet system 406.

FIG. 8 depicts a flow chart that illustrates the steps pertaining to thetechnician during the aforementioned process of replenishing one of thecells 412 in the automated dispensing device 212. At step 800, thetechnician receives a notification on a the pharmacist device 700 thatthe quantity of medications 1000 in one of the cells 412 is less than apredetermined threshold such that replenishment is required. Thetechnician then finds a container 900 (such as a bulk container or adetrash pan) which contains a known quantity of the medication 1000contained in the cell 412. At step 802, the technician scans amachine-readable code (such as a barcode, QR code or the like) on alabel of the container 900 using the imager 714 or a separate scanningdevice on the technician device 700.

FIG. 9 illustrates a technician-performing step 802. At decision step804, the technician device 700 or the external device 704 determines ifthe scan of the code is both recognized and valid, i.e., matches thecode associated with a known type of medication 1000. If the answer atdecision step 804 is no, then the method returns to step 802. If steps802 and 804 are repeated a predetermined number of times (for example,five), then the technician moves to a different container and repeatsstep 802. The container 900 may then be moved to a re-evaluation area todetermine why it was unable to be scanned.

If the answer at decision step 804 is yes, then at step 806, thetechnician takes a picture of the label on a medication container 900and a separate picture of the medications 1000 contained in thecontainer 900 using the imager 714 on the technician device 700. Thetechnician may transfer the medications 1000 from the container to atemporary separate container (such as a clear bag) prior to taking thepicture of the medications 1000. If step 806 is returned to (discussedbelow), then potentially only one of these pictures will be taken ratherthan both. As shown in FIG. 10 , the technician device 702 automaticallydisplays the pictures of the container 900 and the medication 1000 in afirst graphical user interface (GUI). Thus, the technician can view thepictures that were taken. At decision step 808, the techniciandetermines if the images of the container 900 and the medications 1000are adequately clear for submission to the pharmacist. If the answer atdecision step 808 is no, then the method returns to step 806, and thetechnician taps whichever one of the container 900 and medications 1000pictures displayed on the first GUI is not clear and takes a new pictureusing the imager 714 of the technician device 702. Steps 806 and 808 arerepeated until the technician determines that both of these pictures aresufficiently clear for submission to the pharmacist.

If the answer at decision step 808 is yes, then at step 810, thetechnician scans a code and/or a label on the front of the door 416 ofthe cell 412 to be replenished. In the exemplary embodiment, each of thedoors 416 has a label, which shows the medication 1000 contained thereinlooks like. However, in some embodiments, other types of codes or labelsmay be disposed on the outside of the door 416, e.g., text, aQuick-Response (QR) code, or a barcode. At decision step 812, thetechnician device 702 or the external device 704 automaticallydetermines if the cell 412 that was scanned is the correct cell 412 tobe replenished.

If the answer to decision step 812 is no, then at decision step 814, thetechnician (or an external device) determines if the scan at step 810has been performed above a predetermined number of times (for example,three). If the answer at decision step 814 is yes, then the processcontinues to step 816. At step 816, an error message is displayed on thetechnician device 702, and a local pharmacist is automatically calledfor direct assistance to troubleshoot the error. If the answer atdecision step 814 is no, then at step 818, an error message is displayedon the display screen 710 of the technician device 702 indicating theerror and directing the technician to the correct location of the cell412 to be replenished. The process then proceeds back to step 810.

If the answer at decision step 812 is yes, then the process proceeds tostep 820. At step 820, the technician takes a picture of the cell 412 tobe replenished using the imager 714 on the technician device 702. Asshow in FIG. 11 , the technician device 702 automatically displays thepicture of the cell 412 in the first GUI. At decision step 822, thetechnician determines if the image of the cell 412 is clear. If theanswer at decision step 822 is no, then the technician taps the pictureof the cell 412, and the method returns to step 820.

At any time from steps 806, when the technician first sees themedications 1000, through step 822, if the technician notices anythingamiss (for example, a problem with the medications 1000 or with the cell412), then the technician can select a “Quarantine” option on the firstGUI. This will alert the system of the potential problem and will call alocal pharmacist to provide assistance. The medications 1000 may then beremoved from the refilling area and analyzed. The medications 1000 canthen be recertified or discarded.

If the answer at decision step 822 is yes, then the technician selects a“Submit” option on the first GUI, and process proceeds to step 824. Atstep 824, the technician joins a pharmacist queue (discussed in furtherdetail below) and waits for a remote pharmacist to approve the pictures,thereby confirming that the container 900, the medications 1000, and thecell door 416 all match. At steps 826 and 828, the technician device 700remains in a loop until the pharmacist is ready to review the pictures.Specifically, at step 826, the technician device 700 waits apredetermined period of time, and at decision step 828, it is determinedif the pharmacist is ready. If the answer to step 828 is no, then theprocess proceeds back to step 828. Steps 826 and 828 repeat until theanswer to decision step 828 is yes, at which point the process proceedsto decision step 830. At decision step 830, the pharmacist determines ifthe pictures of the container 900, the medications 1000, and the door416 are approved. Further details pertaining to this approval processare discussed in further detail below, with reference to FIG. 12 .

If the answer to decision step 830 is no, then the process proceeds tostep 832. At step 832, the refilling operation is rejected. Followingaction could include, for example, removing the medications 1000 fromthe automated dispensing device 212 area for further analysis. Themedications 1000 can then be either recertified or discarded. Apharmacist or mechanic may also investigate the cell 412 for problems.If the answer to decision step 830 is yes (i.e., the pharmacist approvesthe technician's pictures), then the process proceeds to step 834.

At step 834, the pharmacist unlocks the door 416 to the cell 412 usingthe pharmacist device 702, i.e., a signal is sent from the pharmacistdevice 702 to the controller 706 to unlock the cell door 416. At step836, a notification is sent to the technician device 700 that the cell412 has been unlocked. The alert may be, for example, provided on thedisplay screen 700 of the pharmacist device 700. The technician then hasa predetermined amount of time (for example, ten seconds) to proceed tosteep 838 and open the door 416 of the cell 412 and scan a code (e.g., abarcode or a QR code) on an inside of the door 416 using the camera 714or a separate scanner of the technician device 700. If the technicianfails to open the door 416 prior to the unlocked period of timeexpiring, then the technician can request the pharmacist to re-unlockthe door 416 through the technician device 700.

After step 838, the process proceeds to decision step 840 where thetechnician device 700 or the external device 704 automatically comparesthe scanned code to the code associated with the medication 1000 to berefilled to determine if the code scanned at step 838 was correct. Ifthe answer at decision step 840 is no, then the method proceeds to step816. At step 816, an error message is displayed on the display screen710 of the technician device 700, and a local pharmacist isautomatically called for direct assistance. If the answer at decisionstep 840 is yes, then the process proceeds to step 842.

At step 842, the technician empties the contents of the container 900into the cell 412. At step 844, the technician closes the door 416 andscans or photographs the label on the outside of the door 416, therebymarking the replenishment completed. At decision step 846, thetechnician device 700, the pharmacist device 702, or the external device704 determines if the correct cell 412 was scanned at step 844. If theanswer to decision step 846 is no, then the process continues to step848, and an error message is displayed on the display screen 710 of thetechnician device 700 and a local pharmacist is automatically called toinvestigate. If the answer to decision step 846 is yes, then therefilling operation ends. The technician may then begin a new refillingoperation for a different medication in a different cell of theautomated dispensing device 212.

In the exemplary embodiment, during the entire replenishment operationfrom step 800 to step 846, the technician and the technician device arerestricted to only replenishing a single cell 412. Also, during thereplenishment operation, all of the photographs and scans are uploadedfrom the technician device 700 to a database maintained in the externaldevice 704 along with time stamps and an identification of whichtechnician performed the replenishment operation for long term storage.Thus, in the unlikely event that an error is discovered later on, thecause of the error can potentially be diagnosed using the informationsaved to the database.

Referring now to FIG. 12 , a flow chart illustrating the stepspertaining to the pharmacist during the aforementioned process ofreplenishing one of the cells 412 of the automated dispensing device 212with medications 1000. At step 1200, a second GUI (such as the one shownin FIG. 12 ) containing a queue of one or more technicians who are allawaiting the pharmacist's approval is displayed on the display screen724 of the pharmacist device 702, and the pharmacist selects one of thetechnicians. The second GUI may organize the technicians in the queueaccording to a priority metric (e.g., a priority score) which may bebased on a number of factors including the current medication counts inthe cells 412 to be refilled, the time until more of the medication willbe demanded by the automated dispensing device 212 (based on knownupcoming dispensing events), and the length of time that the technicianassociated with that refill has been waiting. In the exemplaryembodiment, the priority score is on a 1-10 scale with 1 being thehighest priority and 10 being the lowest. In some embodiments, otherpriority scales are used. The second GUI may also identify which cells412 are in the queue, the times that the technicians have been waitingfor the pharmacist, and the medications 1000 waiting to be filled.

After the pharmacist selects one of the technicians from the second GUI,then a third GUI is displayed on the display screen 724 of thepharmacist device 702. An example third GUI is shown in FIG. 14 . In theexemplary embodiment, the third GUI identifies the location of the cell412 to be replenished and the type of medication 1000 assigned to thatcell 900. The third GUI also displays the three pictures taken by thetechnician, namely, the pictures of the container 900, the medications1000, and the label on the cell door 416. Adjacent each of thesepictures are selectable options “Accept” and “Reject”. Further, thethird GUI has a “Reject Replenishment” option which can be selected bythe pharmacist at any time and an “Unlock Cell” option which onlybecomes selectable once the pharmacist has confirmed the clarity of allof the pictures. At decision step 1202, the pharmacist determines if thethree pictures are sufficiently clear for the pharmacist to confirm thatthe correct medication has been chosen by the pharmacist. If the answerto decision step 1202 for any of the pictures is no, then at step 1204,the pharmacist communicates the rejection of that picture to thetechnician by selecting the “Reject” option.

If the answer at decision step 1202 is yes, then at step 1206, thepharmacist reviews the medication information that is associated withthe cell 412 and compares that medication information to the threepictures taken by the technician. At decision step 1208, the pharmacistdetermines if the three pictures all match the medication 900 that isassigned to the cell 412. The pharmacist can confirm this information byselecting “Accept” for each of the pictures on the third GUI.

If the answer at decision step 1208 is no (the pictures do not match thecorrect medication information), then at step 1210, the pharmacistnotifies the technician of the rejection. The pharmacist can processthis rejection by selecting the “Reject Replenishment” option in thethird GUI. At step 1212, the pharmacist documents the reason for therejection using the pharmacist device 702, and that reason is stored inthe database maintained in the memory 736 of the external device 704.The process then returns to aforementioned step 1200. The medication1000 may then be removed from the filling area and analyzed beforeeither being recertified or discarded.

If the answer at decision step 1208 is yes, then at step 1214, thepharmacist selects the “Unlock Cell” option from the third GUI. Thiswill allow the technician to open the cell door 416 and replenish thecell 412 with the medications from the container 900. At step 1216, thepharmacist waits for the technician to complete replenishment of thecell 412 and conduct the final scan of the label on the outside of thedoor 412 (see step 844 of FIG. 8 ). At decision step 1218, thepharmacist determines if the final scan was successful. If the answer todecision step 1218 is no, then at step 1220, the pharmacist contacts afloor pharmacist at the automated dispensing device 212 to conduct aninvestigation. If the answer at decision step 1218 is yes, then thepharmacist's job for this replenishment operation is completed. Thepharmacist may return to step 1200 to begin another replenishmentprocess.

The refilling operation allows a single pharmacist to be responsible forthe approval of a greater number of cells 412 in the automateddispensing device 212 than if the pharmacist must conduct thereplenishment operation on his or her own on location at the automateddispensing device 212 while also reducing the risk of a faultymedication replenishment.

Referring now to FIG. 15 , a flow chart depicting an alternate processfor replenishing a cell in an automated dispensing device is shown. Atstep 1500, the technician scans a code on the label on the container 900with the technician device 700. At decision step 1502, the techniciandevice 700 or the external device 704 automatically determines if thescan of the container 900 was valid. If the answer at decision step 1502is no, then the process proceeds back to step 1500. If step 1500 hasbeen performed more than a predetermined number of times (for example,five), then the process proceeds to step 1504, and the container 900 isisolated. The medications 1000 in the container 900 may then either berecertified or they may be disposed of. If the answer at decision step1502 is yes, then the process proceeds to step 1506.

At step 1506, the display screen 710 of the technician device 700automatically displays information associated with the medicationassociated with the scanned code on the label, and the techniciancompares the medication 1000 with the medication information on thedisplay screen 710. At decision step 1508, the technician determines ifthe medication is valid. If the answer at step 1508 is no, then theprocess proceeds to step 1504, and the container 900 is isolated. If theanswer at decision step 1508 is yes, then the process proceeds to step1510.

At step 1510, the technician analyzes the medications 1000 in thecontainer 900 for validity. Specifically, the technicians searches thecontainer 900 for stray incorrect medications and for brokenmedications. At decision step 1512, the technician determines if themedications 1000 are valid. If the answer at decision step 1512 is no,then process proceeds to step 1504, and the container 900 is isolated.If the answer at decision step 1512 is yes, then the method proceeds tostep 1514.

At decision step 1514, the technician moves to the cell 412 to bereplenished and verifies that the image on the label on the cell door416 matches the medications 1000. At decision step 1516, the techniciandetermines if the image on the cell door 416 matches the medications1000. If the answer at decision step 1514 is no, then the processproceeds to step 1504, and the container 900 is isolated. If the answerat decision step 1516 is yes, then the process proceeds to step 1518.

At step 1518, the technician scans the label on the outside of the celldoor 416 with the technician device 700. At decision step 1520, thetechnician device 700 or the external device 704 determines if the scanis valid. If the answer at decision step 1520 is no, then the processreturns to step 1518. After a predetermined number of invalid scans (forexample, five), then the process proceeds to step 1504, and thecontainer 900 is isolated. If the answer at decision step 1520 is yes,then the process proceeds to step 1522.

At step 1522, the technician takes a picture of one of the container900, the medications 1000, and the cell door 416 using the techniciandevice 700. At decision step 1524, the technician determines if thepicture taken at step 1522 is clear. If the answer at decision step 1524is no, then the method proceeds back to step 1522. If the answer atdecision step 1524 is yes, then the method proceeds to step 1526. Atstep 1526, the technician takes a picture of a second one of thecontainer 900, the medications 1000, and the cell door 416 using thetechnician device 700. At decision step 1528, the technician determinesif the picture taken at step 1526 is clear. If the answer at decisionstep 1528 is no, then the process proceeds back to step 1526. If theanswer at decision step 1528 is yes, then the process proceeds to step1530. At step 1530, the technician takes a picture of the remaining oneof the container 900, the medications 1000, and the cell door 416 withthe technician device 700. At decision step 1532, the techniciandetermines if the picture taken at step 1530 is clear. If the answer atdecision step 1532 is no, then the process proceeds back to step 1530.If the answer at decision step 1532 is yes, then the process proceeds tostep 1534.

At step 1534, the technician selects an option on the technician device700 to send the pictures taken at steps 1522, 1526, and 1530 to thepharmacist. At decision step 1536, the pharmacist determines whether tounlock the cell 416. If the answer at decision step 1536 is no, then thepharmacist transmits to the technician the reason for the rejection, andthe process proceeds to decision step 1538. At decision step 1538, thetechnician determines if he or she is able to correct the error. If theanswer at decision step 1538 is no, then the method proceeds to step1504, and the container 900 is isolated. If the answer at decision step1538 is yes, then the process proceeds to step 1540, and the techniciancorrects the error and contacts the pharmacist. The process thenproceeds back to step 1534.

If the answer at decision step 1536 is yes, then the process proceeds todecision step 1542. At decision step 1542, the technician waits for thecell door 416 to open. If the door 416 does not open after apredetermined period of time, then at step 1544, the technician sends arequest the pharmacist to unlock the door 416. The request may be, forexample, an alert that is displayed on the display screen 724 of thepharmacist device 702. The process then proceeds back to decision step1536. If the answer at decision step 1542 is yes, then then the processproceeds to step 1546.

At step 1546, the technician opens the cell door 416 and scans a code onan inside of the door 416 with the technician device 700. At decisionstep 1548, the technician device 700 or the external device 704automatically determines if the scan of the code on the inside of thecell door 416 is valid. If the answer at decision step 1548 is no, thenthe process proceeds back to step 1546. If the answer is no more than apredetermined number of times (for example, five), then the processproceeds to step 1504, and the container 900 is isolated. If the answerat decision step 1548 is yes, then the process proceeds to step 1550.

At step 1550, the technician replenishes the cell 416 with themedications 1000 from the container 900. At decision step 1552, thetechnician determines if the replenishment was successful. If the answerat decision step 1552 is no, then the process proceeds to step 1554, anda supervisor (for example, a pharmacist on location at the automateddispensing device 212) is notified to assist. If the answer at decisionstep 1552 is yes, then the process proceeds to step 1556.

At step 1556, the pharmacist closes the cell door 416 and scans the codeand/or label on the outside of the cell door 416 with the pharmacistdevice 700. At decision step 1558, the technician device 700 or theexternal device 704 determines if the scan is valid. If the answer atdecision step 1558 is no, then the process proceeds to step 1554, and asupervisor is notified to assist. If the answer at decision step 1558 isyes, then the process is completed.

Implementations of the systems, algorithms, methods, instructions, etc.,described herein may be realized in hardware, software, or anycombination thereof. The hardware may include, for example, computers,intellectual property (IP) cores, application-specific integratedcircuits (ASICs), programmable logic arrays, optical processors,programmable logic controllers, microcode, microcontrollers, servers,microprocessors, digital signal processors, or any other suitablecircuit. In the claims, the term “processor” should be understood asencompassing any of the foregoing hardware, either singly or incombination. The terms “signal” and “data” are used interchangeably.

As used herein, the term module may include a packaged functionalhardware unit designed for use with other components, a set ofinstructions executable by a controller (e.g., a processor executingsoftware or firmware), processing circuitry configured to perform aparticular function, and a self-contained hardware or software componentthat interfaces with a larger system. For example, a module may includean application specific integrated circuit (ASIC), a Field ProgrammableGate Array (FPGA), a circuit, digital logic circuit, an analog circuit,a combination of discrete circuits, gates, and other types of hardwareor combination thereof. In other embodiments, a module may includememory that stores instructions executable by a controller to implementa feature of the module.

Further, in one aspect, for example, systems described herein may beimplemented using a special purpose computer/processor may be utilizedwhich may contain hardware for carrying out any of the methods,algorithms, or instructions described herein. The hardware may become aspecial purpose device when storing instructions, loading instructions,or executing instructions for the methods and/or algorithms describedherein.

Further, all or a portion of implementations of the present disclosuremay take the form of a computer program product accessible from, forexample, a computer-usable or computer-readable medium. The programincludes steps to perform, at least, portions of the methods describedherein. A computer-usable or computer-readable medium may be any devicethat can, for example, tangibly contain, store, communicate, ortransport the program for use by or in connection with any processor.The medium may be, for example, an electronic, magnetic, optical,electromagnetic, or a semiconductor device. Other suitable mediums arealso available.

The above-described embodiments, implementations, and aspects have beendescribed in order to allow easy understanding of the present disclosureand do not limit the present disclosure. On the contrary, the disclosureis intended to cover various modifications and equivalent arrangementsincluded within the scope of the appended claims, which scope is to beaccorded the broadest interpretation to encompass all such modificationsand equivalent structure as is permitted under the law.

What is claimed is:
 1. A system for automated medication dispensing,comprising: an automated dispensing device including a plurality ofcells containing and associated with medications to be dispensed to onesof containers and wherein the cells are locked by a lock that can beelectronically activated; an imager to produce an image of a medicationand to transmit the image of the medication from the imager to anelectronic device that is remote from the imager; the electronic devicebeing configured to compare the image of the medication to a storedmedication image associated with a first cell of the plurality of cellsto determine if medication in the image of the medication is the correctmedication for replenishing the first cell with medication; upon apositive determination, the electronic device initiating an unlocksignal to the automated dispensing device to release the lock at thefirst cell for replenishing the first cell; and the first cell havingthe lock unlocked to allow replenishing the first cell with themedication.
 2. The system of claim 1, wherein the imager includes atechnician mobile device and is operated by a technician on location atthe automated dispensing device, and wherein the electronic device is apharmacist device that is operated by a pharmacist.
 3. The system ofclaim 2, wherein the image is a photograph, and wherein the electronicdevice is further adapted to display the photograph of the medication onthe electronic device along with a photograph of the medicationassociated with the first cell.
 4. The system of claim 2, wherein theimager is adapted to photograph a door of the first cell and transmits apicture of the door from the imager to the electronic device remote fromthe imager; and wherein the electronic device transmits the unlocksignal to the automated dispensing device upon a positive verificationthat the picture of the door shows the first cell.
 5. The system ofclaim 4, wherein the imager is further configured to image a medicationcontainer which contains the medication and to transmit an image of themedication container to the electronic device; and wherein theelectronic device transmits the unlock signal to the automateddispensing device is only in response to a positive verification thatthe image of the medication container shows the correct medicationcontainer for replenishing the first cell.
 6. The system of claim 4,wherein the imager is further configured to image medication in themedication container and to transmit an image of the medication to theelectronic device.
 7. The system of claim 4, wherein the imager isfurther configured to image a dispenser medication in the automateddispensing device and to transmit an image of the dispenser medicationto the electronic device.
 8. The system of claim 1, wherein theelectronic device transmits the unlock signal to the automateddispensing device only in response to a positive verification that theimage of the medication container shows a correct medication containerfor replenishing the automated dispensing device.
 9. The system of claim1, wherein the imager locks from scanning images after a number ofimages that are invalid exceeds a threshold number of image attempts.10. A system for automated medication dispensing, comprising: anautomated dispensing device including a plurality of cells containingand associated with medications to be dispensed to ones of containersand wherein the cells include cell doors that are locked by a lock thatcan be electronically activated; an imager to produce an image of amedication container and to transmit the image of the medicationcontainer from the imager to an electronic device that is remote fromthe imager; the electronic device being configured to compare the imageof the medication container to a stored medication image associated witha first cell of the plurality of cells to determine if a medicationassociated with the image of the medication container has a correctmedication for replenishing the first cell with medication; upon apositive determination that the correct medication is in the medicationcontainer for the first cell, the electronic device initiates an unlocksignal to the automated dispensing device to release the lock at thefirst cell for replenishing the first cell; and the first cell havingthe lock unlocked to allow replenishing the first cell with themedication in the medication container.
 11. The system of claim 10,wherein the imager is further configured to send a request to openmessage to the electronic device over an electronic communicationchannel.
 12. The system of claim 10, wherein the imager is furtherconfigured to scan a machine readable code inside the door of the firstcell after the lock is unlocked and the door is open.
 13. The system ofclaim 12, wherein the imager is further configured to check the scannedmachine readable code with a stored file, if there is a match confirmreplenishment of the first cell with the medication in the medicationcontainer and if there is not a match signal an error to notreplenishment of the first cell with the medication in the medicationcontainer.
 14. The system of claim 13, wherein the imager is furtherconfigured to image the door after replenishment of the first cell withthe medication from the medication container to confirm replenishment ofthe first cell.
 15. A system for automated medication dispensing,comprising: an automated dispensing device including a plurality ofcells containing and associated with respective medications to bedispensed to containers and wherein the cells are locked by a lock thatcan be remotely electronically activated; an imager to produce an imageof a medication or a medication container and to transmit the image fromthe imager to an electronic device that is remote from the imager; theelectronic device being configured to allow comparison of the image to astored medication image associated with a first cell of the plurality ofcells to determine if medication associated with the image is a correctmedication for replenishing the first cell with medication; upon adetermination that medication associated with the image is the correctmedication, the electronic device initiating an unlock signal to theautomated dispensing device to release the lock at the first cell forreplenishing the first cell; and the first cell having the lock unlockedremotely to allow replenishing the first cell with the medication in themedication container, wherein the imager images a machine readable codein the first cell to further confirm the correct medication for thefirst cell.
 16. The system of claim 15, wherein the automated dispensingdevice signals a replenishment signal when a medication quantity in thefirst cell falls below a threshold value to trigger replenishment of themedication in the first cell.
 17. The system of claim 15, wherein theimager is configured to: scan a machine readable code inside the door ofthe first cell after the lock is unlocked and the door is open, checkthe scanned machine readable code with a stored file, if there is amatch confirm replenishment of the first cell with the medication in themedication container and if there is not a match signal an error to notreplenishment of the first cell with the medication in the medicationcontainer, and image the door after replenishment of the first cell withthe medication from the medication container to confirm replenishment ofthe first cell.
 18. The system of claim 15, wherein the electronicdevice transmits the unlock signal to the automated dispensing deviceonly in response to a positive verification that the image of themedication container shows a correct medication container forreplenishing the automated dispensing device.
 19. The system of claim15, wherein the imager locks from scanning images after a number ofimages that are invalid exceeds a threshold number of image attempts.20. The system of claim 15, wherein the imager is to: image a door ofthe first cell, transmit a picture of the door from the imager to theelectronic device remote from the imager, image a medication containerwhich contains the medication, and transmit an image of the medicationcontainer to the electronic device; and wherein the electronic device isto transmit the unlock signal to the automated dispensing device only inresponse to a positive verification that the image of the medicationcontainer shows the correct medication container for replenishing thefirst cell and the image of the door shows the first cell.